Outreach Program

Adult presentation booking request

Complete this form to request a presentation at your aged care facility. It is a condition of booking that at least one support staff member from the centre attends the presentation.

We plan all of our visits to incorporate as many requests as possible. It may be some months before we can confirm this year’s travel schedule but we will contact you as soon as we can.

Your details will be entered into the Outreach Program client database so that we can contact you in future.

Read our booking conditions and cancellation policy before proceeding.

Organisation details All fields are required
Invoicing details If different from above
Personal details All fields are required
Presentation and venue details All fields are required unless specified
  • Will there be anyone with Alzheimer’s disease or dementia in attendance?
Timetable Please complete with the full timetable for your group
Security question